GB2381197A - A surgical implant - Google Patents

A surgical implant Download PDF

Info

Publication number
GB2381197A
GB2381197A GB0125565A GB0125565A GB2381197A GB 2381197 A GB2381197 A GB 2381197A GB 0125565 A GB0125565 A GB 0125565A GB 0125565 A GB0125565 A GB 0125565A GB 2381197 A GB2381197 A GB 2381197A
Authority
GB
United Kingdom
Prior art keywords
screw
head
plate
surgical implant
plug
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
GB0125565A
Other versions
GB0125565D0 (en
Inventor
Simon Nicholas Collins
David Mark Fletcher
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Corin Surgical Ltd
Corin Ltd
Original Assignee
* CORIN SURGICAL LIMITED
CORIN SURGICAL LTD
Corin Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by * CORIN SURGICAL LIMITED, CORIN SURGICAL LTD, Corin Ltd filed Critical * CORIN SURGICAL LIMITED
Priority to GB0125565A priority Critical patent/GB2381197A/en
Publication of GB0125565D0 publication Critical patent/GB0125565D0/en
Publication of GB2381197A publication Critical patent/GB2381197A/en
Application status is Withdrawn legal-status Critical

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8033Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8038Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers the additional component being inserted in the screw head
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7059Cortical plates
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Threaded wires, pins or screws; Nuts therefor
    • A61B17/8625Shanks, i.e. parts contacting bone tissue
    • A61B17/8635Tips of screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Threaded wires, pins or screws; Nuts therefor
    • A61B17/8685Threaded wires, pins or screws; Nuts therefor comprising multiple separate parts

Abstract

A surgical implant, typically a cervical plate assembly, comprises a plate 10 having at least two apertures 11 and two screw threaded fastening devices 13 for securing the plate to bone. Each aperture in the plate has an annular groove 16 intermediate opposite ends of the aperture and each fastening device 13 comprises an outer screw 14 and an inner plug 15. The screw 14 has a head 18 at one end, a tip at the other end, an externally threaded shank 19 between the head and the tip and an internal bore 20 extending axially through the head and at least part way into the shank for receiving the inner plug. The head comprises a plurality of resiliently deformable fingers 22 separated by one another by axially extending slits 23. Each finger 22 has an outwardly projecting rib 24 extending circumferentially the head intermediate opposite ends of the finger for snap fit engagement in the annular groove of a respective plate aperture. The inner plug is arranged so that when it is inserted into the internal bore of the screw it will prevent contraction of the head of the screw thereby preventing the ribs disengaging from the groove.

Description

23811 97

A SURGICAL IMPLANT

This invention relates to a surgical implant and more particularly, but not exclusively, to a cervical plate assembly for stabilising the cervical spine.

Plates are commonly used to connect two separated pieces of bone. These plates immobilise the broken bone pieces while the bone pieces fuse together.

Cervical plates are commonly used for anterior spine stabilisation to assist fusion in cases of degenerative disease, tumours, fractures and partial or total vertebrectomy.

10 The plates are fixed to the bone by screws. It is known to provide the screws with expansion cones to expand the tip of the screw after insertion of the latter in the bone.

This results in secure fixation. However, it is often difficult in young patients or in good quality bone to expand the tip of the screw.

15 It is known from US-A-4484570 to expand the head of the screw to provide secure fixation of the screw to the plate. However, this suffers from the disadvantage that a force arises from the tapered mating of the inner and outer screws which may contribute to loosening and subsequent screw pull out leading to failure of the device.

20 According to the present invention Here is provided a surgical implant comprising a plate having at least two apertures and two screw threaded fastening devices for securing the plate to bone, each aperture in the plate having an annular

groove intermediate opposite ends of the aperture and each fastening device comprising an outer screw and an inner plug, the screw having a head at one end, a tip at the other end, an externally threaded shank between the head and the tip and an internal bore extending axially through the head and at least part way into the shank 5 for receiving the inner plug, the head comprising a plurality of resiliently deformable fingers separated from one another by axially extending slits, each finger having an outwardly projecting rib extending circumferentially of the head intermediate opposite ends of the finger for snap fit engagement in the annular groove of a respective plate aperture, and the inner plug being arranged so that when it is inserted into the internal 10 bore of the screw it will prevent contraction of the head of the screw thereby preventing the ribs disengaging from the groove.

Preferred and/or optional features of the invention are set forth in claims 2 to 9, inclusive.

The invention will now be more particularly described, by way of example, with reference to the accompanying drawings, in which: Figure 1 is a perspective, partially exploded, view of one embodiment of a 20 surgical implant according to the present invention, Figure 2 is a section taken through Figure 1, and

Figure 3 is a view similar to Figure 2 of a second embodiment.

Referring to the drawings, the surgical implant shown therein is in the form of a cervical plate assembly used for stabilising the cervical spine of a patient. The 5 assembly comprises a cervical plate 10 having an aperture 11 adjacent each corner.

It may also have a central aperture (not shown) to allow attachment of a bone graft to aid fusion. The plate 10 is of contoured non-planar shape and is available in various sizes so that a surgeon can select an appropriate plate which will not result in penetration of the intervertebral disc space by the fastening devices referred to 10 below.

The assembly comprises four screw threaded fastening devices 13 for securing the plate 10 to bone. Each fastening device 13 comprises an outer screw 14 and an inner plug 15.

Each aperture 11 in the plate has an annular groove 16 intermediate the outer and inner ends of the aperture and an annular ledge 17 between the annular groove 16 and the inner end of the aperture 11.

20 Each outer screw 14 comprises a head 18, an externally threaded shank 19 and an internal bore 20 extending axially through the head 18 and through the shank 19 for receiving the plug 15.

The bore 20 has a first portion 20a in the head 18 of the screw 14, a second portion 20_ extending into the shank 19 from the portion 20_ and a third portion 20c extending from the portion 20b through the tip of the screw 13. The portion 20_ is of larger diameter than the portion 20c and the portion 20_ is of larger diameter than 5 the portion 20b. The portion 20b of the bore 20 is internally screw threaded for a purpose which will become apparent.

The tip of the screw 13 has four equi-angularly spaced, axially extending slits 21 which allow the tip to be outwardly deformed in a manner to be described 10 hereinafter.

The plug 15 has a head portion 15_ which is a close fit in the portion 20_ of the bore 20, an externally threaded shank 15b which threadably engages the portion 20b of the bore 20 and an expansion element 15_ of slightly larger diameter than the 15 portion 20c of the bore 20 for outwardly deforming the tip end of the screw 14.

The tip of the expansion element 15c is tapered or part spherical in order to assist insertion of the expansion element 15_ into the bore portion 20_.

20 The head 18 of the screw 14 comprises a plurality of resiliently deformable fingers (in this case three) 22 separated from one another by axially extending slits 23. Each finger 22 has an outwardly projecting rib 24 extending circumferentially

s of the head 18 intermediate opposite ends of the finger 22 for snap fit engagement in the annular groove 16 of a plate aperture 11. As shown, the rib 24 is inwardly tapered towards the tip of the screw but this need not necessarily be the case.

5 The head portion 15a of the plug 15 has a non-circular, and as shown hexagonal, socket 15_ for receiving an insertion tool.

In order to fLx the cervical plate assembly to the cervical spine, the outer screws 14 are screwed into bone through the apertures 11 by a known tubular screw 10 driver until the head 18 of the screw 14 abuts the ledge 17 in the aperture and the ribs 24 snap fittably engage in the groove 16. The plug 15 is then inserted and screwed into place by a hexagonal screw driver inserted through the tubular screw driver, the latter acting as a guide and preventing the screw 14 from turning during insertion of the plug 15. When the plug 15 is fully in place, the head 15a of the plug is a close 15 fit in the portion 20_ of the bore 20 in the screw and this prevents contraction of the head 18 of the screw hereby preventing the ribs 24 disengaging from the groove 16.

Also, the expansion element 15_ expands the tip of the screw 13 to improve the overall fixation and prevent pull out of the fastening devices.

20 In some circumstances, it will be difficult to expand the tip of the screw 13 and in such cases a different plug having no expansion element will be used.

The plate 10, screws 14 and plugs 15 are made of suitable biocompatible material, typically commercially pure or alloyed titanium.

The embodiment shown in Figure 3 differs from that shown in Figure 2 in that 5 the portion 20_' of the bore 20' in the screw has an annular groove 30 to receive an annular rib 31 on the head 15a' of the plug 15 as a snap fit.

The implant described above is in the form of a cervical plate assembly.

However, me invention is equally applicable to any plates used to immobilise broken 10 bone pieces. Thus, the plate may take other forms and may, for example, have only two apertures.

The embodiments described above are given by way of example only and various modifications will be apparent to persons skilled in the art without departing 15 from the scope of the invention as defined by the appended claims. For example, the plug could be a push fit in the bore of the screw.

Claims (12)

1. A surgical implant comprising a plate having at least two apertures and two screw threaded fastening devices for securing the plate to bone, each aperture in the 5 plate having an annular groove intermediate opposite ends of the aperture and each fastening device comprising an outer screw and an inner plug, the screw having a head at one end, a tip at the other end, an externally threaded shank between the head and the tip and an internal bore extending axially through the head and at least part way into the shank for receiving the inner plug, the head comprising a plurality of 10 resiliently deformable fingers separated from one another by axially extending slits, each finger having an outwardly projecting rib intermediate opposite ends of the finger for snap fit engagement in the annular groove of a respective plate aperture, and the inner plug being arranged so that, when it is inserted into the internal bore of the screw, it will prevent contraction of the head of the screw thereby preventing 15 the ribs disengaging from the groove.
2. A surgical implant as claimed in claim 1, wherein the plug comprises a head which is a close fit in that part of the internal bore extending through the head of the screw and an externally threaded shank which is screw threadably engageable with 20 an internal Tread on at least part of the bore in the shank of the screw.
3. A surgical implant as claimed in claim 1 or claim 2, wherein each plate aperture
has an annular ledge between the annular groove and the inner end of the aperture for engagement by the inner end of the screw head when the ribs are in snap fit engagement with the annular groove.
5
4. A surgical implant as claimed in any one of the preceding claims, wherein the head of the plug has a non-circular socket for receiving a tool for inserting the plug in the internal bore of the screw.
5. A surgical implant as claimed in any one of the preceding claims, wherein the 10 internal bore extends throughout the entire length of the screw, the tip end of the screw being outwardly deformable and the tip end of the plug including an expansion element for outwardly deforming the tip end of the screw as the plug is inserted in the internal bore.
15
6. A surgical implant as claimed in claim 5, wherein the tip end of the screw has a plurality of axially extending slits.
7. A surgical implant as claimed in any one of the preceding claims, wherein each rib is tapered inwards towards the tip of the screw.
8. A surgical implant as claimed in any one of the preceding claims, wherein the plug is snap fittably engageable in the screw.
9. A surgical implant as claimed in any one of the preceding claims, wherein the plate is a cervical plate.
10. A surgical implant as claimed in claim 9, wherein the plate has at least four 5 apertures.
11. A surgical implant as claimed in claim 9 or claim 10, wherein the plate is non planar. 10
12. A surgical implant substantially as hereinbefore described with reference to the accompanying drawings.
GB0125565A 2001-10-25 2001-10-25 A surgical implant Withdrawn GB2381197A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
GB0125565A GB2381197A (en) 2001-10-25 2001-10-25 A surgical implant

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
GB0125565A GB2381197A (en) 2001-10-25 2001-10-25 A surgical implant
EP02254774A EP1306058A3 (en) 2001-10-25 2002-07-08 A surgical plate implant
US10/192,324 US6613053B1 (en) 2001-10-25 2002-07-11 Surgical implant

Publications (2)

Publication Number Publication Date
GB0125565D0 GB0125565D0 (en) 2001-12-19
GB2381197A true GB2381197A (en) 2003-04-30

Family

ID=9924467

Family Applications (1)

Application Number Title Priority Date Filing Date
GB0125565A Withdrawn GB2381197A (en) 2001-10-25 2001-10-25 A surgical implant

Country Status (3)

Country Link
US (1) US6613053B1 (en)
EP (1) EP1306058A3 (en)
GB (1) GB2381197A (en)

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US6613053B1 (en) 2003-09-02
EP1306058A3 (en) 2003-06-25
US20030171753A1 (en) 2003-09-11
EP1306058A2 (en) 2003-05-02
GB0125565D0 (en) 2001-12-19

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